What are we studying? Abnormal Behaviour Psychopathology Mental Disorder Mental Illness Deviant Behaviour
The study of mental disorder involves: Definition: What do we mean by mental disorder? Classification: How do we distinguish between different mental disorders? Explanation: How do we understand mental disorder? Treatment: How do we treat mental disorder?
Why study abnormal psychology? Abnormal behaviour is part of our common experience Lots of unanswered questions and complexities Preparation for future careers www.apa.org/students/
Mental Health Professionals Clinical Psychologist (Ph.D., C. Psych.) Psychiatrist (M.D.) Psychiatric Social Worker (M.S.W.) Psychoanalyst Therapist
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What do we mean by mental disorder? Who has a mental disorder? Mass murders? People who want to cut off their arms and legs? People who can’t pay attention and concentrate?
Is the concept of ‘Mental Disorder’ problematic? “I should like to make clear, therefore, that although I consider the concept of mental illness to be unserviceable, I believe that psychiatry could be a science. I also believe that psychotherapy is an effective method of helping people – not to recover from an ‘illness’ but rather to learn about themselves, others and life.” Szasz
Why clarify the definition of mental disorder? Influences what is seen as pathological Influences explanation, classification and treatment Clarifies the role of professionals
Why clarify the definition of mental disorder? Safe-guard against abuses Clarify contentious cases
Two broad ways to define mental disorder In general, the concept of “mental disorder” can be defined as: A biomedical, culturally independent, value-free concept Or as a social, culturally relative, value-based concept.
Overview of definitions that will be discussed Mental disorder as a statistical deviation Mental disorder as dysfunction Mental disorder as personal discomfort Mental disorder as maladaptive behaviour Mental disorder as norm or value violation
Mental disorder as statistical deviance A person has a mental disorder when their behaviour, ability, or experience is significantly different from average.
Problems: We want to use the term disorder to describe some conditions that are statistically frequent “positive” deviations are not distinguished from “negative” deviations we do not want to call all “negative deviations a disorder
Uggo Betti: “All of us are mad. If it weren’t for the fact that every one of us is slightly abnormal, there wouldn’t be any point of giving each person a separate name.”
Mental disorder as a dysfunction A person has a mental disorder when a mental mechanism is not performing the natural function it was designed to perform. Problems: Natural selection does not “design” mechanisms
Sedgwick (1982): “All sickness is essentially deviancy from some alternative state of affairs which is considered more desirable…The attribution of illness always proceeds from the computation of a gap between presented behaviour (or feeling) and some social norm.”
Mental disorder as a dysfunction Problems cont: For many mechanisms there is a wide range of adaptive functioning across people and situations (fear response).
Mental disorder as a dysfunction Problems cont: Many things that we want to call a disorder might actually be adaptive reactions.
Mental disorder as personal discomfort A person has a mental disorder if they experience personal distress. Problems: What about the person who abuses drugs or believes they are receiving messages from outer-space – without experiencing distress?
Mental disorder as maladaptive behaviour A person has a mental disorder if they engage in behaviour that prevents them from meeting the demands of life. Problems: There may be situations that people should not adapt to This approach emphasizes “fitting in” as being ultimately important
Mental disorder as norm or value violation A person has a mental disorder if they have experiences and exhibit behaviours that are inconsistent with the norms and values of society. Examples: Behaviour that is harmful to oneself or others Poor reality contact Inappropriate emotional reactions Erratic behaviour
Mental disorder as norm or value violation Problems: What if violation is result of external circumstances Such a criteria can seem too arbitrary and open to abuse
DSM-IV definition of mental disorder A mental disorder is “conceptualized as a clinically significant behavioural or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.”
DSM-IV definition of mental disorder “The syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one.” “It must currently be considered a manifestation of a behavioural, psychological, or biological dysfunction in the individual.”
Cross cultural issues How one thinks about the role of culture depends on your definition of mental disorder
Cross cultural issues If biomedical, then culture influences how a disorder impacts members of different cultures Different risk Idiom of distress
Cross cultural issues If culturally based, then influences what will be considered a disorder Behaviour or experience may not be a “disorder” in all cultures
Non-Western approaches to mental disorder Often do not separate psychology and spirituality Disruption in relation to spirit world Often based on more collective and less individualistic conceptualizations Disruption in interpersonal relations
The study of mental disorder involves: Definition: What do we mean by mental disorder? Categorization: How do we classify mental disorder? Explanation: How do we understand mental disorder? Treatment: How do we treat mental disorder?
Further exploration: Linienfeld, S. O., & Marino, L. (1995). Mental Disorder as a Roschian Concept: A critique of Wakefield’s “Harmful Dysfunction” analysis. Journal of Abnormal Psychology, 104(3), 411- 420. Szasz, T. (2000). Second commentary on “Aristotle’s function argument. Philosophical Psychiatry and Psychology 7(1), 3-16. Wakefield, J. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47(3), 373-388.